Off-Campus Permissions Form

Today's Date

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Student's First and Last Name

First Name

Last Name

Off-Campus Permissions

Off-Campus Permissions Overview

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Before completing the following section, please review the Off-Campus Permissions overview at the link above and below.

Off Campus Permissions Overview: https://www.notion.so/heartwoodalc/Off-Campus-Permissions-Overview-0ffdf7d1c5188092810cfbee98fd8995?pvs=4 Off-campus Privileges are offered as an opportunity for students to go off-campus WITHOUT a facilitator. (* Off-campus trips WITH a facilitator are considered 'field trips.') The permissions for each student are individual and are based on what feels like a comfortable match for the student, the family, and the facilitators. Off-campus Privileges are structured by location. Please indicate below which locations are approved for your student and what size group they need to be in to travel. Please visit your Caregiver Dashboard to read more details about Off-Campus Privileges.

Here are the Tiers and the requirements you can select for each location:

Group of 5 - Must have 2 cell phones, a Facilitator's phone number, 1 hour time limit, and 1 trip per day Group of 3 - Must have at least 1 cell phone, a Facilitator's phone number, 1 hour time limit, and 1 trip per day Solo - Must have a cell phone, a Facilitator's phone number, 1.5 hour time limit, and multiple trips per day Prerequisite for ALL Off-Campus Choices - Take a training course on code-switching, safety, dealing with curious adults, police, potential adult perceptions, assumptions, etc.

Does your Student have a Cell Phone?

If Yes, please provide their phone number.

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Vending Machine and Benches

Refuge Coffee

Thriftown and Family Dollar

Friendship Forest, Milam Park, 40 Oaks

Library

PATH Trail

If you selected Other, for any of the Above Locations - Please list below your Preference

Other Off-Campus Permissions

Is there a location that you are ok with that your student can go that is not listed above? If so, please notate below and with requirements.

Off-Campus Permissions Form

Your last page of the application will be submitting a tuition offer, coming up next. Thank you so much!